Our Ultimate Guide to Workers’ Compensation Canada is meant to be a resource for Canadians who have been injured at work. It covers the process to follow when you are injured at work, the types of benefits that are available through workers’ compensation, how to apply and appeal a denial, and more.
Disclaimer: This guide is for general information purposes only. For more specific information, visit your provincial workers’ compensation website — links to each program are provided below.
- What is Workers’ Compensation in Canada?
- Hurt at Work? Next Steps
- Applying for Workers’ Compensation Benefits Canada
- What Should You Expect After Reporting an Injury?
- Types of Workers’ Compensation Benefits in Canada
- Interaction of Workers’ Compensation Benefits and Long-Term Disability Benefits
- What Happens if Your Injury Prevents You From Returning to Your Old Position?
- Workers’ Compensation Benefits Denied
- Workers’ Compensation Programs by Province and Territory
- Workers’ Compensation Advocates by Province and Territory
- Final Thoughts
- Free Case Evaluation
What is Workers’ Compensation in Canada?
Before we dive into the details of applying, returning to work and appealing a denial, let’s start with the basics. Starting with what even is workers’ compensation?
Each province in Canada has its own workers’ compensation program that pays disability income to workers who are injured while at work. To be eligible for workers’ compensation payments, you must work for a covered employer and suffer a work-related injury or illness. If you qualify for workers’ compensation benefits, you can receive disability income payments to age 65 and sometimes longer. You may also qualify for other benefits, including payment of health care and equipment expenses as well as payment for pain and suffering.
What are workers’ compensation benefits?
Workers’ compensation benefits vary from province to province, but they normally will include a mix of income payments, medical expense benefits, and income cases compensation or pain and suffering.
Eligibility for workers’ compensation benefits
Each provincial workers’ compensation program has its own eligibility criteria, but generally, they all include the following:
- Your employer has coverage through workers’ compensation; and
- You have suffered a work-related injury or illness.
Deadlines to apply for workers’ compensation benefits
All workers’ compensation programs include strict deadlines to file a claim for benefits. The deadlines can vary from program to program but are usually six months from the date of injury or illness. With some limited exceptions, it is critical that you file a claim for workers’ compensation before the deadline.
Hurt at Work? Next Steps
Now that you understand the fundamentals, let’s discuss what steps you should take after suffering a workplace injury or illness.
Report the injury or illness
If possible, the first thing you should do is report the injury or illness to a supervisor or manager. With that said, if you are severely injured, your first priority should be getting to a hospital as soon as possible.
After reporting the injury, there is also a form that needs to be filled out, which documents the incident. The form number varies by province, but there is an accident report for each workers’ compensation program. This form needs to be completed by you and someone in a senior position. Once it’s completed, it needs to be sent to your provincial workers’ compensation program.
Seek medical care
The next thing you should do is seek medical care as soon as possible and ensure that you tell the healthcare provider this injury is from a workplace accident. There are also specific workers’ compensation forms for healthcare providers that need to be filled in and submitted. Seeking medical care quickly will help your claim. Make sure your physician knows the details of the accident and reports all the injuries you have, even if they cannot give an official diagnosis of them. If this is the case, they can document where you were injured, what tests need to be administered and discuss future treatment recommendations. Once you’re finished with your initial appointment, schedule a follow-up appointment with a medical care provider.
Applying for Workers’ Compensation Benefits Canada
All the workers’ compensation programs in Canada share a similar application process. They require the worker to report the illness or injury as soon as possible. Most programs have a six-month deadline to file a report of injury or illness. Each program has its own injury report form. You apply by filing an injury report and sending it to the workers’ compensation program office.
You can find all the required forms on your province’s website. Once you submit forms from your employer and healthcare team, workers’ compensation will usually open a claim file for you. In some cases, you may need to fill out an additional form to report the injury.
Submit all required forms to the workers’ compensation agency as quickly as possible. While waiting for their decision on your claim, you should attend all recommended medical treatment.
What Should You Expect After Reporting an Injury?
If the injury was mild and you require no time off from work, you most likely won’t hear from them at all. If the injury is more severe and you have had to take time off work, you should hear from them within two weeks — that is, if you have completed all the necessary forms.
Once you have sent in all the forms, you can call their general line and get your claim number. With that information, you can register for their online services, which will enable you to see whether your claim is being assessed and when you will receive a decision. You can also use the online portal to send in additional documentation, such as doctors’ notes and test results. Before they decide, a case worker will contact you by phone and ask questions about the incident. They may also ask for more information about the injury and your current treatment plan.
Types of Workers’ Compensation Benefits in Canada
Once the workers’ compensation agency has approved your claim, there are different benefits you can receive. Unlike other disability providers, workers’ compensation offers more than just wage-loss benefits. And claimants can receive one or all of these benefits.
In this section, we will overview some of the most common benefits offered by workers’ compensation.
Wage loss benefits
The most common benefit offered by workers’ compensation is wage loss. This benefit replaces a percentage of your working income while you are too injured to do your job. The percentage varies from province to province. So, you will need to check the workers’ compensation website in your area to see what percentage of wage loss is covered.
Typically, the program only covers income from the job you were injured at, and there is usually a cap on the benefit. So, if you earn more than the specified threshold, unfortunately, you won’t receive more money. However, if you have a disability plan through insurance, they may cover the difference. Always apply for all disability benefits available to you.
Workers’ compensation also covers medical expenses associated with the claim (e.g., physiotherapy, surgery, medications, travel costs, medical devices, etc.). You can send receipts for these things, or they will set them up and preapprove them prior to the treatments. It varies from province to province. Occasionally they will also cover travel expenses if you must travel for medical treatments.
Permanent Impairment Benefit
Another common benefit is the permanent impairment benefit. This is compensation for the fact that you are left with a permanent impairment. Workers Compensation will only make permanent injury assessments once your injury has reached maximum recovery. Maximum recovery means all available treatments have been exhausted (i.e., physiotherapy and surgeries are completed and healed). Generally, these assessments happen around two years after the injury, but again it can vary depending on the injury.
The permanent injury will be assessed by an independent medical examiner selected by workers’ compensation. You will be given a percentage of total body impairment, and they will use this percentage to calculate the benefit. This benefit is vastly different in each province. Some are paid by lump sum, others are paid out monthly, and some offset your wage loss benefits. For more information on how your program calculates and pays this benefit, visit your province’s workers’ compensation website.
The benefits listed above are the most common types of benefits from workers’ compensation. There can be others, depending on the severity of the injury, such as home care or assistance with certain tasks. To receive any type of benefits, you will need medical evidence to prove they are necessary.
Interaction of Workers’ Compensation Benefits and Long-Term Disability Benefits
If you are covered by both workers’ compensation and long-term disability insurance, then it is critical that you apply to both programs. Failing to apply to both programs is a common mistake that may result in you being denied benefits under both programs. Seeking to avoid workers’ compensation claims, some employers will try to push workers into only applying for disability insurance benefits when in fact, the worker should be applying to both programs. This is a common mistake that can result in the employee being denied benefits under both programs for technical reasons, even though they are otherwise legitimately disabled.
What Happens if Your Injury Prevents You From Returning to Your Old Position?
Some workplace injuries will prevent you from returning to your previous position. The outcome of this can vary depending on the severity of the injury, your employer, or your skills, training, and education. If the injury is severe and prevents you from ever doing any work again, workers’ compensation will cover you until age 65 for ongoing wage loss and permanent impairment benefits.
And depending on your age, they may put a percentage of your benefits away to be paid to you monthly upon turning age 65. This is designed to act as a retirement plan. For more information on this, visit the workers’ compensation website in your province.
However, keep in mind that continued long-term benefits are a last resort for them, and it will take anywhere from two to four years before this will happen. They will exhaust all possibilities before paying these benefits. For example, they will ensure you have tried all forms of treatment and may develop various return-to-work plans. Throughout this process, you should do your best to work with them and complete everything they’ve asked of you – even if you disagree with them. Get legal advice before refusing to do anything recommended by workers’ compensation.
If the injury prevents you from going back to your previous job, there are a few different things that can happen. For example, they may ask your employer if they can offer you a position within your restrictions. They may also ask, depending on your skills and history, to investigate other forms of employment. And they will give you information on what types of roles they believe you can do with your impairment.
Reeducation or Re-training
In some cases, they will ask you to participate in reeducation or training for a new job that you can do with your restrictions. It is especially important that you attempt these recommendations. Refusal to participate is not an option. If you truly feel it will cause harm, you need to get medical evidence to show exactly why you cannot comply with their requests. However, even then, your claim may be in jeopardy. We always suggest doing your best to comply with their requests unless completely necessary.
Workers’ Compensation Benefits Denied
A denial can happen at various times and for varying reasons. Workers’ compensation can also deny different parts of your claim. For example, they can deny wage loss, stating they believe you can work while still agreeing to cover your medical expenses. They can also deny types of treatments or extended care. Denials do happen.
When some part of your claim is denied, you will receive a call from your case manager, followed by a letter with an explanation of the denial. The denial letter is a crucial piece of information and needs to be paid close attention to. The denial letter will explain the reasoning and what you can do about the decision.
Each province has different rules when it comes to denials and appeals. Normally the first step is a reconsideration appeal. If that appeal is denied, then you typically appeal to an independent tribunal which will give a final decision. Appeals beyond the independent tribunal can only deal with errors of law, so it is essential that you present all evidence in your Tribunal Appeal.
However, as stated earlier, it differentiates in each province. You should pay close attention to what step you are on as it is extremely important to work within the strict deadline outlined in the denial letter. Visit your province’s website for more specific information about the appeal process in your area.
Workers’ Compensation Programs by Province and Territory
As discussed earlier, each province has its own workers’ compensation program. The rules and benefits are unique to each program. So, for more detailed information, click on the websites provided below.
|Alberta||Workers Compensation Board of Alberta|
9912 017 Street
PO Box 2415
Edmonton, AB T5J 2S5
Tel: 1-866-922-9221 (toll-free)
|British Columbia||WorksafeBC (Workers’ Compensation Board of British Columbia)|
Main Office: 6551 Westminster Highway
General Mailing Address: PO Box 5350 Stn Terminal
Vancouver, B.C. V6B 5L5
Tel: 1- 888-967-5377 (toll-free)
|Manitoba||Workers Compensation Board of Manitoba|
333 Broadway St.
Winnipeg, MB R3C 4W3
Tel: 1-855-954-4321 (toll-free)
1 Portland St.
PO Box 160
Saint John, NB E2L 3X9
|Newfoundland and Labrador||Workplace Health, Safety & Compensation|
Commission of Newfoundland and Labrador
146-148 Forest Rd.
PO Box 9000
St. John’s, NL A1A 3B8
Tel: 1-800-563-9000 (toll-free)
|Northwest Territories and Nunavut||Workers Compensation Board of the Northwest Territories and Nunavut|
5022 49th Street, 5th Floor
Centre Square Tower PO Box 8888
Yellowknife, NT X1A 2R3
Tel: (800) 661-0792 (toll-free)
|Nova Scotia||Workers’ Compensation Board of Nova Scotia|
5668 South St.
PO Box 1150
Halifax, NS B3J 2Y2
Tel: 1-800-870-3331 (toll-free)
|Ontario||Workplace Safety and Insurance Board |
200 Front Street West
Toronto, Ontario M5V 3J1
Tel: 1-800-387-0750 (toll-free)
|Prince Edward Island||Workers’ Compensation Board of Prince Edward Island|
14 Weymouth St.
PO Box 757
Charlottetown PE C1A 7L7
Tel: 1-800-237-5049 (toll-free)
|Quebec||Commission des norms, de l’équité, de la santé et de la sécurité due travail (CNESST)|
524, rue Bourdages
Quebec, Qc G1K 7E2
|Saskatchewan||Saskatchewan Workers’ Compensation Board|
200-1881 Scarth St.
Regina, SK S4P 4L1
Tel: 1-800-667-7590 (toll-free)
|Yukon||Yukon Worker’s Compensation, Health and Safety Board|
401 Strickland St.
Whitehorse, YK Y1A 5N8
Tel: 800-661-0443 (toll-free)
Workers’ Compensation Advocates by Province and Territory
Each province and territory has a free legal clinic to represent workers who need to appeal claim denials from the workers’ compensation board. These legal clinics are funded by the provincial government but are independent of the workers’ compensation programs. Each of these legal clinics has its own rules for and criteria for who is eligible for their services. You must contact these clinics to see if they can represent you in your appeal.
|Alberta||Office of the Appeals Advisor|
|British Columbia||Workers Advisors Office|
|Manitoba||Worker Advisor Office|
|New Brunswick||Worker’s Advocate|
Email: [email protected]
|Newfoundland and Labrador||Worker’s Advisor|
|Northwest Territories and Nunavut||Workers’ Advisors Office|
|Nova Scotia||Workers’ Advisor Program|
|Ontario||Office of the Workers Advisor|
|Prince Edward Island||Worker Advisor Program|
|Quebec||Service des plaints|
|Saskatchewan||Office of the Workers’ Advocate|
This is a general outline of the workers’ compensation programs in Canada. Each provincial workers’ compensation program has its own unique rules and requirements. So, you need to visit your provincial program’s website to learn exactly what you need to do throughout the claims process. With that said, there are a few general things everyone should keep in mind – regardless of where you live.
First, quick reporting and medical treatment are important in any disability claim but especially with workers’ compensation. There are deadlines in each province for reporting an injury, and if you do not report it within those time limits, you may be ineligible to receive any benefits for the injury. So, do not wait to report the injury! There are also deadlines to appeal a denial, so make sure to meet those deadlines as well.
It is also important to continue to treat your injury — even after your claim has been accepted. Make sure to follow up with your healthcare provider and do everything you can to get better. You must also complete all treatments outlined by workers’ compensation. However, keep your healthcare provider informed about how you are responding to these treatments. If something isn’t working, talk to your doctor about it, and you can come up with an alternative plan. Workers’ compensation just wants you to get better so you can return to work. That is their goal. So, it is important that you are doing everything you can to try and reach that goal with them.
Finally, for many people, the advocates provided by workers’ compensation are a great option. However, it is important to note that in some situations, independent representation may be a better fit.
Free Case Evaluation
Resolute Legal is one of the few law firms in Canada that focus exclusively on disability claims. We can represent you in all your claims, including short-term disability, long-term disability, CPP disability, worker’s compensation, employment disputes, and the disability tax credit.
We currently only represent people in workers’ compensation cases in the Atlantic provinces. And we only take on clients who have been denied wage loss benefits. So, if you require different services, we recommend contacting another firm or utilizing the free legal services provided by provincial workers’ advocates.
Interested in hiring a lawyer? Call our disability support team today at (888) 732-0470 today for a free case evaluation.